The landmark building 10 s Clinton street Suite 10 lower level Doylestown PA 1890
How our ODD program came to be...
Hello I'm Lynne Welsh. Our ODD program was born from my work with oppositional teens about ten years ago. I stumbled upon a client with ODD who my colleague felt I was the best fit to work with. I met this client and knew I could help them and together we made a great team. I began to dive into the research and literature on the subject and consulted with specialists in the field and had some success with these kids. I built a program that is comprehensive and attempts to cover all bases. With ODD the treatment is rarely smooth sailing or a linear progression. There are many bumps along the way in the treatment....three steps forward and two steps back..
I am honest with parents from the start that an oppositional defiant child is not a "bad" kid. Their behaviors and ways of expressing anger may be challenging and feel near impossible to parents at times, but generally ODD develops from a good kid that had no choice but to decide to act in ways that felt less vulnerable to them.
I have found that ODD can begin with an anxious child who at some point, if the anxiety is not treated, can shut down into depersonalization and be so far from their feelings that they may decide that they no longer want to feel vulnerable all day every day and can turn those feelings into something that appears tougher and cooler which may mean acting like the bad kid at home and/or school.
ODD could also be from a child with untreated ADHD earlier in life. Because the ADHD is not treated they may feel like the "stupid or dumb" kids in class and at home they may be called "lazy" because they cannot focus enough to stay on task with chores. At some point one untreated mental health issue leads to another and parents have a child who is angry, acting out, and being impulsive with behaviors and choices. Often kids will tell me "My teachers and parents were calling me a bad kid, so I figured I might as well be a bad kid." Or "You say I'm bad, I will show you how bad I can be."
There are many other diagnosis and issues that, left untreated, can develop into ODD behaviors.
How we treat ODD: It takes a Village
Our ODD program does not involve once a week therapy. Our program is customized to every child and family. It can consist of one or more of the following :
-therapy sessions....... one or more per week. The therapist has to be available for calls/text in between sessions when the family is in crisis with the ODD teen.
-a teen mentor.....assigned to your child for times when they need to just talk it out and be heard. This is not a therapist
-an executive functioning coach.......to help with their student portal, organizing a weekly calendar for assignments and constant follow up with the coach to review if the work has been complete. This takes parents out of the power struggle of fighting with their child about school work.
-psychiatrist/medication....we have partnered with a team of psychiatric providers to help us with our teen clients. They love working with teens and teens feel they can be open and connect with our psychiatric partners.
-family therapy......this is essential for the therapy with the oppositional client to be effective. This will be another therapist in our practice.
-parent support therapist........this will be another therapist in our practice who has knowledge and experience with ODD
-sibling therapy......if the siblings are being affected by the oppositional teen. ODD can be traumatizing for siblings.
The Village: Types of treatment for your child with ODD:
DBT.....dialectical behavior therapy is a type of therapy where clients learn skills to deal with emotional regulation, triggers as they come up, and stress tolerance. Often ODD kids are not able to manage any of these things and what ensues when they have a feeling or are triggered is mayhem for all involved.
PSYCHOANALYTIC PSYCHOTHERAPY....in the individual therapy sessions a combination of psychodynamic therapy along with DBT will be utilized. The therapy will focus on helping our ODD clients understand how this all began, what they were feeling before the ODD symptoms began, and how this evolved. We will also explore the shame that can come with ODD behavior that comes from parents trying to help and discipline their child for the oppositional behavior.
PSYCHIATRIC CONSULT...if a client has not had a psychiatric consult we quickly will schedule them with our Eileen Pierce, Psychiatric NP, who has a great deal of experience with ODD. She will attempt to diagnose the root cause of the oppositional behavior and begin to treat it.
EMDR....EMDR is a trauma based rapid eye movement therapy. If we find our ODD teen has trauma that could be helped with EMDR we have a referral partner who is also in Doylestown who has two practitioners who are highly skilled in EMDR and have done great work with our clients and with consent from the client are able to collaborate with us as a team in the treatment.
EDUCATIONAL THERAPY...If your child is struggling with academics we partner with an Executive Functioning Coach who will not only help them with their schoolwork but calm them down each session and help them settle their emotions from earlier in the day.
PSYCHOLOGICAL/EDUCATIONAL TESTING & ASSESSMENT: If needed we will refer to you a practice we partner with to determine the exact cause of the educational challenges of your child. If your child has a questionable psychological diagnosis this practice can do the testing to pinpoint the exact diagnosis
IOP/PHP/INPATIENT CONSULTING: If at any point in the treatment, we recommend a higher level of care because your child is not safe for whatever reason, we have a consultant who can talk with you as parents to find the best fit for your child and assist you in finding out what programs are covered by your insurance.
ADOLESCENT INPATIENT ADVOCATE: If as a last resort, your child has to go inpatient we have an advocate who can advocate for your child and act as liaison with your family and the facility so your child is not dropped off and left alone at a facility.
GOALS OF TREATMENT
(1) To begin to stabilize and de-escalate your child's acting out oppositional behaviors, parents and therapists create a plan together to set firm boundaries and provide structure in the home.
(2) To remove parents from years of being the bad guy and allow the therapist to move into that position. This can allow the space to begin to prepare the parent/child relationship.
(3) Together the parents and therapist will work through ways to respond to your child's behavior so it is not reactive and does not escalate and create more divide in the family
(4) )With the higher level of boundaries and structure in place and parents not reacting to their child's acting out behavior.
(5) Once things begin to take hold and the new plan is working we can begin to explore with your child how this all began, how they are feeling about past behavior, address any shame or trauma associated with the act-out behavior and any guilt associated with hurting the family in the process. We can also address the conflict and damage the incidents have caused in the family.